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DSH260091M SSM HEALTH ST MARY'S HOSPITAL-STL (Active)
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Main Details
Name
SSM HEALTH ST MARY'S HOSPITAL-STL
Subdivision Name
SSM Cardinal Glennon at Lake St. Louis
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260091M
Medicare Provider Number
260091
Outpatient Facility Provider Number
260091
Additional Details
Current Program Status
Active
Registration Date
7/7/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/15/2014
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
SSM Health
Eileen Lamm, Regional Vice President-Finance
(314) 994-6219
Primary Contact
SSM Health
Holly Herring, Director, 340B Center of Excellence
(580) 512-7188
Addresses
Street Address
301 Caledonia Parkway
220
O'Fallon, MO 63368
Billing Address
SSM ST Mary's CG at Lake STL
1465 South Grand Boulevard
St Louis, MO 63104
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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